Tag Archives: comfort items

Everyone who works in corrections is familiar with inmates wanting medical authorization to wear their own shoes. A typical case would go something like this: “I have chronic back pain and walking on these hard concrete floors makes it worse. Will you authorize me to wear my own shoes? You did last time I was in here and it really helped.”

We need to keep in mind, however, that allowing an inmate to wear his own shoes gives that inmate secondary gain. Shoes from home are, indeed, more comfortable than the typical jail sandals. Also, any inmate who is granted a special privilege, like wearing his own comfy shoes, gains status among the other inmates. When we approve inappropriate requests for “own shoes,” we are bestowing prestige upon that inmate. And we are denying that prestige to those who we refuse. The unfairness of this is not lost on inmates. Finally, “own shoes” are occasionally used to smuggle contraband into the facility. I remember one pair that had an ingenious hollow space carved out of the sole that was not easy to find on a typical security examination. If you routinely grant requests for “own shoes,” you will inevitably get burned in this way. Continue reading →

I have a quick ‘n easy solution for those pesky requests for a second mattress that plague all correctional facilities. But before I get to that, though, there are two important points to consider in any discussion about second mattresses in correctional facilities.

First, providing inmates with mattresses, like inmate clothes and toiletries, is the purview and duty of the correctional officers, not the medical staff. What this means is that when an inmate asks for a second mattress, the question being put to us is this: Is there a medical need for this patient to have a second mattress? This is critically important. The inmate would prefer to frame the question differently, something like this: “The correctional officers only issued me one mattress, but you can over-rule them and authorize me to have a second mattress. Will you do me this favor?” This is a totally different question than “Does this patient have a medical need for a second mattress.”

Secondly, having a second mattress is a status symbol inside the correctional community. When an inmate receives a benefit that other inmates do not, he gains status and prestige. Sometimes this motivation is as important for an experienced inmate as is the extra comfort of a second mattress. I believe that if a jail provided two mattresses to every inmate in the facility, there would be requests to medical for three mattresses. (Pretty soon inmate beds would rival “The Princess and the Pea!”) So when we grant inappropriate requests for second mattresses, we are conferring status on the inmate in question. And we are denying status to those who we refuse. This also, in my mind, is important to consider.

So now to the main topic of the day: What constitutes a “medical need” for a second mattress? In my opinion—there are none! Zero. Nada. There is no medical need ever for a second mattress. I challenge anyone to find a reference in any medical literature saying that second mattresses are a treatment for anything. For example, a common reason given by inmates requesting a second mattress is that they have chronic back pain. However, if you pull out any medical textbook that deals with the treatment of chronic back pain, you will not find second mattresses mentioned in any. Go ahead! Look!

About

Jeffrey E. Keller is a Board Certified Emergency Physician with 25 years of emergency medicine practice experience before moving full time into his “true calling” of Correctional Medicine. He is the Medical Director of Badger Medical, which provides medical services to several jails and juvenile facilities in Idaho. Dr. Keller is available for consultation on any aspect of Correctional Medicine, including legal cases, program development, and system analysis.

Expert Consultation in Correctional Medicine

Dr. Keller is available for consultation on any aspect of Correctional Medicine, including legal cases, program development, and system analysis. Dr. Keller has wide experience in both jail and prison systems and in both clinical practice and administration. Read more

Join the American College of Correctional Physicians!

The American College of Correctional Physicians is the professional organization for correctional practitioners. ACCP needs you! ACCP provides these services: